CMS revokes PET infection, inflammation imaging barrier

By AuntMinnie.com staff writers

August 6, 2021 -- The U.S. Centers for Medicare and Medicaid Services (CMS) has removed the final coding barrier for F-18 FDG PET imaging of infection and inflammation, according to the Society of Nuclear Medicine and Molecular Imaging (SNMMI).

In its Transmittal 10927 on August 2, CMS revoked noncovered codes for osteomyelitis and fever of unknown origin that had been listed as noncovered in a previous transmittal from June by CMS. Although CMS had retired the longstanding National Coverage Determination (NCD) for F-18 FDG PET imaging of infection and inflammation in December 2020, the June transmittal had unexpectedly listed ICD-10-CM codes for some osteomyelitis and fever of unknown origin codes as nationally noncovered under the infection and inflammation NCD that was retired, the SNMMI said.

The new transmittal clarifies that, with the NCD no longer in effect, overage determinations will now be made by local Medicare administrative contractors, the SNMMI said. The society said that it worked with the American College of Radiology and the American Society of Nuclear Cardiology on the effort to get CMS to change its policies on F-18 FDG PET imaging of infection and inflammation.


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